The Relationship of Moral Reasoning and AIDS Knowledge to Risky Sexual Behavior

Article excerpt

Human immunodeficiency virus (HIV), the virus responsible for acquired immune deficiency syndrome (AIDS), was isolated and identified in the early 1980s (Barre-Sinoussi et al., 1983; Gallo et al., 1984). Subsequently, AIDS has come to be recognized as the most serious infectious disease epidemic of modern times (e.g., Kulstad, 1988). Diverse sections of society, including government agencies, the mass media, and individual celebrities, have responded to this epidemic primarily with information campaigns, both about the manner in which the virus is transmitted and the steps individuals can take to decrease their risk of exposure (Ford & Norris, 1991; Gray & Saracino, 1989; Weinman, Smith, & Mumford, 1992).

Despite the rapid proliferation of AIDS prevention campaigns, the high rate of infection among adolescents and young adults indicates that these information campaigns are not effective (Barinaga, 1990; Biemiller, 1991; Bowler, Sheon, D'Angelo, & Vermund, 1992). The failure of these campaigns on college campuses has been noted with alarm by health practitioners and researchers alike (Baldwin & Baldwin, 1988; Biemiller, 1991; Debuono, Sinner, Daamen, & McCormack, 1990). The failure of prevention efforts is often attributed to two assumptions purported to be made by most adolescents and young adults: (a) that they do not belong to one of the stereotypical target groups (Gray & Saracino, 1989), and (b) that they are not personally vulnerable to the AIDS virus (Bowler et al., 1992; Siegel & Gibson, 1988).

Although adolescents' and young adults' continued engagement in risky sexual behaviors may be related to these two assumptions, there are alternative explanations. The purpose of the research reported in the current paper was to examine two of these alternatives: (1) the possibility that moral reasoning is related to engaging in risky sexual behaviors; and (2) the possibility that the relationship between knowledge of information about AIDS and decreases in risky sexual practices is mediated by moral reasoning.

Risky sexual behaviors in the AIDS era can be grouped into three categories: (1) participation in any one of the sexual activities that involve passage of bodily fluids, (2) lack of condom use during such activities, and (3) inadequate discrimination rules for choosing sexual partners (i.e., have sexual encounters with multiple partners, or with partners who have had multiple partners). The occurrence of any one of these activities is risky. More than one of these behaviors, in any combination, further increases an individual's overall total risk (e.g., Bowler et al., 1992; Kelly, St. Lawrence, Hood, & Brasfield, 1989).

Decisions regarding whether to engage in sexual activity have long been included in the category of moral dilemmas (Gilligan, Kohlberg, Lerner, & Belenky, 1971; Juhasz & Sonnenshein-Schneider, 1987; Mitchell, 1975). Mitchell (1975) notes that the conflict between the desire for sexual expression and an adherence to moral beliefs is often one of the first times an adolescent recognizes that moral beliefs do not always correspond with personal desires. Further, the cognitive deliberation adolescents engage in while making decisions about sexual behavior is consistent with the kinds of cognitive deliberation classified as moral reasoning (Gilligan et al., 1971).

Although some pre-AIDS research examined the relationship between moral reasoning and sexual behavior (see Jurich & Jurich, 1970; Jurs, 1984; D'Augelli & Cross, 1975; Gerrard & Gibbons, 1982), this research must be replicated and extended in light of new considerations related to AIDS. Concerns about pregnancy or the attitudes of others are often overshadowed by the threat of death from the AIDS virus. In addition, not only is the individual's own death a possibility, but so also is the death of the current sexual partner, the future partners of either current partner, and the future partners of any of those future partners. …